Purpose:To evaluate subclinical macular findings in premature patients at risk of retinopathy of prematurity (ROP) with the use of handheld spectral domain-optical coherence tomography (SD-OCT).

Methods:Thirty-five patients ages 30 weeks gestation to 57 weeks gestation were imaged using Bioptigen Hand Held Probe SD-OCT (HHP-SDOCT) (Bioptigen, Research Triangle Park, NC, USA). Images were acquired in non-sedated infants in the neonatal intensive care unit or outpatient clinic during ROP screening examinations. Informed consent was obtained and all research was approved by the local institutional review board. Some subjects were followed and re-imaged over the course of several weeks. One hundred ninety-six total images were acquired, and one eye from each patient was evaluated for cystoid macular edema (CME) and persistence of inner retinal layers.

Results:One hundred eighteen (60.2%) of the images were usable (defined as having scans passing through the fovea with clearly identifiable retinal layers). CME was seen in 5 of 17 eyes (29.4%) with stage 0 ROP, 0 of 2 eyes (0%) with stage 1 ROP, 1 of 5 eyes (20%) with stage 2 ROP, and 0 of 3 eyes (0%) with stage 3 ROP. Persistence of inner retinal layers was seen in 17 of 17 eyes (100%) with stage 0 ROP, 2 of 2 eyes (100%) with stage 1 ROP, 4 of 5 eyes (80%) with stage 2 ROP, and 3 of 3 eyes (100%) with stage 3 ROP.

Conclusions:Consistent with previous reports (Vinekar A, et al. IOVS 2011;52:5183-5188; Maldonado RS, et al. Ophthalmology 2011;118:2315-2325), subclinical CME is seen in premature infants; however, CME does not appear to be correlated with ROP stage. This suggests that there may be other etiologies for the CME seen in this patient population. Our data suggests there is persistence of inner retinal layers in premature infants, regardless of ROP stage. Hand-held SD-OCT imaging is a viable technique for evaluating subclinical macular findings in premature infants, though much larger datasets are needed from multiple centers to develop a better understanding of what is "normal" and what truly represents subclinical pathology.